A Randomized Study in Children Ages Birth Through Three Years Undergoing Unilateral Cataract Extraction With or Without Lens Replacement (ILR7)

A Randomized, Double-Masked, Parallel-Group, Phenylephrine-Controlled Study of the Effect of OMS302 Added to Standard Irrigation Solution on Intraoperative Pupil Diameter and Acute Postoperative Pain in Children Ages Birth Through Three Years Undergoing Unilateral Cataract Extraction With or Without Lens Replacement

The purpose of this study is to evaluate the effect of OMS302 compared to phenylephrine when administered in irrigation solution during cataract extraction on intraoperative pupil diameter, acute postoperative pain, and safety in children birth through 3 years.

Study Overview

• Status: Completed
• Conditions: Congenital Cataract; Unilateral Cataract Extraction
• Intervention / Treatment: Drug: OMS302; Drug: Phenylephrine HCl

Detailed Description

This study is a randomized, parallel-group, double-masked, phenylephrine-controlled study of OMS302 in young children ages birth through three years undergoing unilateral cataract extraction with or without lens replacement. Administration of test irrigation solutions will take place in a double-masked fashion.

Intraoperative pupil size will be determined by measurement of pupil diameter from still photos captured from video recordings of the procedure. Pupil diameter measurements will be performed immediately prior to the initial incision and at one-minute intervals until the end of the procedure (wound closure). Pain will be assessed by the Alder Hey Triage Pain Score.

• Study Type: Interventional
• Enrollment (Actual): 78
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • California
    • Los Angeles, California, United States, 90027
  • Georgia
    • Atlanta, Georgia, United States, 30322
  • Illinois
    • Chicago, Illinois, United States, 60611
  • Indiana
    • Indianapolis, Indiana, United States, 46202
  • Kansas
    • Kansas City, Kansas, United States, 66103
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
  • Michigan
    • Detroit, Michigan, United States, 48201
  • North Carolina
    • Charleston, North Carolina, United States, 29425
  • Tennessee
    • Nashville, Tennessee, United States, 37232
  • Texas
    • Dallas, Texas, United States, 75390
  • Wisconsin
    • Madison, Wisconsin, United States, 53705

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 day to 3 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Are 0 through three years of age at the time of surgery.
2. Are to undergo unilateral primary cataract extraction with or without lens replacement.
3. Have informed consent and Health Insurance Portability and Accountability Act (HIPAA) Authorization provided by a parent or legal guardian in accordance with local regulations and governing IRB/IEC requirements prior to any procedures or evaluations performed specifically for the sole purpose of this study.
4. A parent or legal guardian has indicated that they understand and are able, willing, and likely to fully comply with study procedures and restrictions.

Exclusion Criteria:

1. Corneal diameter less than nine millimeters in the study eye.
2. Hypersensitivity to phenylephrine, ketorolac, or other NSAIDs, including aspirin, or latex.
3. Surgeon's expectation that the protocol-specified mydriatic regimen will not be adequate to perform the procedure and that additional mydriatic treatment (pharmacological or mechanical) will be required.
4. Presence of clinically significant gastrointestinal, cardiovascular, hepatic, renal, hematological, endocrine, neurological, psychiatric, respiratory, or other medical condition that could increase the risk to the subject as determined by the Investigator.
5. Presence of active or suspected viral, bacterial, or fungal disease in the study eye.
6. Use of any topical medication in the study eye within seven days prior to surgery, except for medications needed to examine the eye or prepare for surgery.
7. Have a post-traumatic cataract.
8. History of uveitis or evidence of past uveitis such as synechiae or keratic precipitates in the study eye.
9. Have an ocular neoplasm in the study eye.
10. Have a clinically significant infection.
11. Have suspected permanent or low vision in the fellow non-study eye, unless caused by a cataract. The study eye must not be the subject's only good eye.
12. Use of systemic corticosteroids or NSAIDs in the seven days prior to surgery.
13. Have a history of clinically significant corticosteroid-induced intraocular pressure increase.
14. Use of any medication for ocular hypertension or glaucoma in the study eye.
15. Use of monoamine oxidase inhibitors for 21 days preoperatively.
16. Prior participation in a clinical study of OMS302.
17. Participating in any investigational drug or device trial within the 30 days prior to the day of surgery.
18. History of intraocular non-laser surgery in the study eye within the three months prior to the day of surgery, or intraocular laser surgery in the study eye within 30 days prior to the day of surgery.
19. Presence of any condition that the Investigator believes would put the subject at risk or confound the interpretation of the study data.
20. Be a member of the immediate family of the Investigator or employees of the investigative site. Immediate family is defined as the Investigator's or employees' natural or legally adopted child (including a stepchild living in the Investigator's household), or grandchild.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: OMS302; OMS302 diluted in balanced salt solution (BSS) and administered as irrigation solution	Drug: OMS302
Active Comparator: Phenylephrine HCl; Phenylephrine diluted in balanced salt solution (BSS) and administered as irrigation solution	Drug: Phenylephrine HCl

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intraoperative Pupil Diameter	Mean Area-under-the-Curve (AUC) Analysis of Change From Baseline in Pupil Diameter (mm/min) During Surgery Excluding Subjects with In-evaluable Videos.	From surgery baseline (pre-incision) through surgery end (time of cortical clean-up/wound closure), the mean time of surgery duration is 35.46 minutes with a standard deviation of 19.98.
Acute Postoperative Pain	Mean AUC Analysis of Postoperative pain as measured using the Alder Hey Triage Pain Score at 3, 6, 9, and 24 hours after surgery. The primary analysis of Alder Hey Triage Pain Score was similar to the primary analysis of the change in pupil diameter using AUC. The Alder Hey Triage Pain Score identifies five categories of observations: voice/cry, facial expression, posture, movement, and color. Each of these has a possible score of 0, 1, or 2, resulting in a total score ranging between 0 and 10. A total score of zero means the subject experienced no pain, as the 5 categories added up totals zero. A total score of 10 means the subject experienced a lot of pain and is the worst possible outcome, as the 5 categories added up totals 10. Parent responses in a diary with a score of 0, 1, or 2.; Cry or voice, 0=no compliant/cry, 1=Consolable, 2=Inconsolable; Facial Expression, 0=Normal, 1=Short grimace <50% of time, 2=Long grimace >50% of time; Posture, 0=Normal, 1=Touching/rub	24 hours
Safety as Measured by Treatment-emergent Adverse Events, the Number of Affected Patients/at Risk (%) and the Number of Events.	Safety as assessed by the incidence of adverse events and serious adverse events up until the last visit at Day 90.	90 days

Collaborators and Investigators

• Sponsor: Omeros Corporation
• Investigators: Study Director: Steve Whitaker, MD, Omeros Corporation

Publications and helpful links

General Publications

• Wilson ME, Trivedi RH, Plager DA. Safety and efficacy data supporting U.S. FDA approval of intracameral phenylephrine and ketorolac 1.0%/0.3% for pediatric cataract surgery: clinical safety and pupil and pain management. J Cataract Refract Surg. 2020 Jun;46(6):873-878. doi: 10.1097/j.jcrs.0000000000000194.

Study record dates

Study Major Dates

• Study Start: July 1, 2014
• Primary Completion (Actual): September 12, 2016
• Study Completion (Actual): September 12, 2016

Study Registration Dates

• First Submitted: May 1, 2014
• First Submitted That Met QC Criteria: May 6, 2014
• First Posted (Estimate): May 7, 2014

Study Record Updates

• Last Update Posted (Actual): July 22, 2021
• Last Update Submitted That Met QC Criteria: July 1, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: pediatric; Cataract; Lens replacement
• Additional Relevant MeSH Terms: Eye Diseases; Lens Diseases; Cataract; Physiological Effects of Drugs; Adrenergic Agents; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Autonomic Agents; Peripheral Nervous System Agents; Protective Agents; Adrenergic alpha-Agonists; Adrenergic Agonists; Cardiotonic Agents; Respiratory System Agents; Sympathomimetics; Vasoconstrictor Agents; Mydriatics; Nasal Decongestants; Adrenergic alpha-1 Receptor Agonists; Phenylephrine; Oxymetazoline
• Other Study ID Numbers: OMS302-ILR-007